Spectrum of injuries associated with paediatric ACL tears: an MRI pictorial review

OBJECTIVE: Magnetic resonance imaging (MRI) findings in anterior cruciate ligament (ACL) injury are well known, but most published reviews show obvious examples of associated injuries and give little focus to paediatric patients. Here, we demonstrate the spectrum of MRI appearances at common sites of associated injury in adolescents with ACL tears, emphasising age-specific issues. METHODS: Pictorial review using images from children with surgically confirmed ACL tears after athletic injury. RESULTS: ACL injury usually occurs with axial rotation in the valgus near full extension. The MRI findings can be obvious and important to management (ACL rupture), subtle but clinically important (lateral meniscus posterior attachment avulsion), obvious and unimportant to management (femoral condyle impaction injury), or subtle and possibly important (medial meniscocapsular junction tear). Paediatric-specific issues of note include tibial spine avulsion, normal difficulty visualising a thin ACL and posterolateral corner structures, and differentiation between incompletely closed physis and impaction fracture. CONCLUSION: ACL tear is only the most obvious sign of a complex injury involving multiple structures. Awareness of the spectrum of secondary findings illustrated here and the features distinguishing them from normal variation can aid in accurate assessment of ACL tears and related injuries, enabling effective treatment planning and assessment of prognosis. TEACHING POINTS: • The ACL in children normally appears thin or attenuated, while thickening and oedema suggest tear. • Displaced medial meniscal tears are significantly more common later post-injury than immediately. • The meniscofemoral ligaments merge with the posterior lateral meniscus, complicating tear assessment. • Tibial plateau impaction fractures can be difficult to distinguish from a partially closed physis. • Axial MR sequences are more sensitive/specific than coronal for diagnosis of medial collateral ligament (MCL) injury

Effects of light and soil flooding on the growth and photosynthesis of ramin (Gonystylus bancanus) seedlings in Malaysia

We studied the ecophysiology of ramin (Gonystylus bancanus) seedlings in an experimental set up at the Forest Research Centre in Kuching, Sarawak, Malaysia. Ramin seedlings were grown on flooded and drained peat soil under 100, 76, 46 and 23% sunlight, thus simulating effects of different light conditions (canopy gap size) and drainage that occur in natural ramin populations. Seedling growth was highest in partial sunlight (76%) and reduced with reducing light levels. Aboveground productivity and fine root development were significantly higher in seedlings grown on flooded soil compared with those on drained soil. In contrast, investment in coarse root biomass was significantly higher in seedlings grown on drained soil. It appeared that the aboveground growth benefits in flooded conditions were the result of more advantageous conditions for allocation of carbon to leaves, thus enhancing overall relative growth rates through higher light interception rates despite lower photosynthetic capacity. The results of this experiment suggested that drainage of peat swamp forests would seriously hamper natural regeneration of ramin by limiting the growth of seedlings. It is also suggested that selective logging operations which produce medium-size canopy gaps improve ramin regeneration in hydrologically undisturbed mixed swamp forest

Nuclear targeting of the serine protease granzyme A (fragmentin-1)

Cytolytic granule-mediated target cell killing is effected in part through synergistic action of the membrane-acting protein perforin and serine proteases such as granzymes A (GrA) or B (GrB). In the present study we examine GrA cellular entry and nuclear uptake in intact mouse myeloid FDC-P1 cells exposed to perforin using confocal laser scanning microscopy, as well as reconstitute GrA nuclear uptake in vitro. GrA alone was found to be able to enter the cytoplasm of intact cells but did not accumulate in nuclei. In the presence of perforin, it specifically accumulated in the cell nuclei, with maximal levels about 2.5 times those in the cytoplasm after 2. 5 hours. In vitro, GrA accumulated in the nucleus and nucleolus maximally to levels that were four- and sixfold, respectively, those in the cytoplasm. In contrast, the active form of the apoptotic cysteine protease CPP32 did not accumulate in nuclei in vitro. Nuclear/nucleolar import of GrA in vitro was independent of ATP and not inhibitable by the non-hydrolyzable GTP analog GTPgammaS, but was dependent on exogenously added cytosol. Importantly, GrA was found to be able to accumulate in the nucleus of semi-intact cells in the presence of the nuclear envelope-permeabilizing detergent CHAPS, implying that the mechanism of nuclear accumulation was through binding to insoluble factors in the nucleus. GrB was found for the first time to be similar in this regard. The results support the contention that GrA and GrB accumulate in the nucleus through a novel nuclear import pathway, and that this is integral to induction of the nuclear changes associated with cytolytic granule-mediated apoptosis.David A. Jans, Lyndall J. Briggs, Patricia Jans, Christopher J. Froelich, Gayathri Parasivam, Sharad Kumar, Vivien R. Sutton and Joseph A. Trapan

MRI of the axial skeleton in spondyloarthritis : the many faces of new bone formation

Spondyloarthritis has two hallmark features: active inflammation and structural lesions with new bone formation. MRI is well suited to assess active inflammation, but there is increasing interest in the role of structural lesions at MRI. Recent MRI studies have examined the established features of new bone formation and demonstrated some novel features which show diagnostic value and might even have potential as possible markers of disease progression. Although MRI is not the first imaging modality that comes into mind for assessment of bony changes, these features of new bone formation can be detected on MRI-if one knows how to recognize them. This review illustrates the MRI features of new bone formation and addresses possible pitfalls

The Role of Community in Understanding Involvement in Community Energy Initiatives

Community energy initiatives are set up by volunteers in local communities to promote sustainable energy behaviors and help to facilitate a sustainable energy transition. A key question is what motivates people to be involved in such initiatives. We propose that next to a stronger personal motivation for sustainable energy, people’s perception that their community is motivated to engage in sustainable energy and their involvement in the community (i.e., community identification and interpersonal contact) may affect their initiative involvement. We tested this proposition with a questionnaire study among inhabitants of seven local communities (N = 439). Results suggested that community factors are uniquely related to initiative involvement (willingness to actively participate and attendance of an initiative meeting) next to personal sustainable energy motivations. In particular, stronger community identification and more interpersonal contact with other community members increased the likelihood that people become involved in a community initiative, but the perception of the sustainable energy motivation of one’s community was not uniquely related to initiative involvement. We discuss theoretical and practical implications of these findings

Diagnositic value of pelvic enthesitis on MRI of the sacroiliac joints in enthesitis related arthritis

Background: To determine the prevalence and diagnostic value of pelvic enthesitis on MRI of the sacroiliac (SI) joints in enthesitis related arthritis (ERA). Methods: We retrospectively studied 143 patients aged 6-18 years old who underwent MRI of the SI joints for clinically suspected sacroiliitis between 2006-2014. Patients were diagnosed with ERA according to the International League of Associations for Rheumatology (ILAR) criteria. All MRI studies were reassessed for the presence of pelvic enthesitis, which was correlated to the presence of sacroiliitis on MRI and to the final clinical diagnosis. The added value for detection of pelvic enthesitis and fulfilment of criteria for the diagnosis of ERA was studied. Results: Pelvic enthesitis was seen in 23 of 143 (16 %) patients. The most commonly affected sites were the entheses around the hip (35 % of affected entheses) and the retroarticular interosseous ligaments (32 % of affected entheses). MRI showed pelvic enthesitis in 21 % of patients with ERA and in 13 % of patients without ERA. Pelvic enthesitis was seen on MRI in 7/51 (14 %) patients with clinically evident enthesitis, and 16/92 (17 %) patients without clinically evident enthesitis. In 7 of 11 ERA-negative patients without clinical enthesitis but with pelvic enthesitis on MRI, the ILAR criteria could have been fulfilled, if pelvic enthesitis on MRI was included in the criteria. There is a high correlation between pelvic enthesitis and sacroiliitis, with sacroiliitis present in 17/23 (74 %) patients with pelvic enthesitis. Conclusions: Pelvic enthesitis may be present in children with or without clinically evident peripheral enthesitis. There is a high correlation between pelvic enthesitis and sacroiliitis on MRI of the sacroiliac joints in children. As pelvic enthesitis indicates active inflammation, it may play a role in assessment of the inflammatory status. Therefore, it should be carefully sought and noted by radiologists examining MRI of the sacroiliac joints in children

Gastropod Community On Seagrass Ecosystem in Makalisung coast

The aim of the research is to know various species of gastropods and gastropod community structure through species density, percent density, dominant species, and association of species of gastropods on seagrass ecosystem. Research with the method of quadrat transect is put perpendicular to the coastline. Gastropod species are found in the seagrass ecosystem on the Makalisung coast consist of 9 species, 7 families, and 4 ordos. Gastropod community structure on seagrass ecosystem is found with species density is highest Cymbiola nivosa as big as 0.64 (ind/m2) with highest percent density 34.04 %. Diversity of species of gastropods on four-station that H’> 1 highest in fouth station as big as H’= 1.72. The dominance of species is highest Cymbiola nivosa as big as C=0.44, where the result of research in generally dominancy C 1 di mana tertinggi stasiun 4 sebesar H’= 1,72; dominansi total tertinggi adalah spesis Cymbiola nivosa sebesar C=0,44, di mana hasil penelitian secara umum dominansi C < 0,25 adalah tergolong rendah. Asosiasi spesis gastropoda di ekosistem lamun ditemukan tiga ciri, (1) klasifikasi golongan asosiasi positif adalahCypraea tigris dan Monetaria annulus,Cypraea tigris dan Cymbiola nivosa, Strombus labiatus dan Cyclope pellucida, Strombus labiatus dan Cymbiola nivosa, Monetaria annulus dan Cerithiun nodulosum, Cymbiola nivosa dan Cerithiun nodulosum; Cerithiu nodulosum dan Angaria dephinus dan Faunus ater. Klasifikasi golongan tidak berasosiasi (2) Angaria dephinus dan asosiasi mendekati zero (0,04) yaitu Monetaria annulus dan Cymbiola nivosa. Dan klasifikasi golongan asosiasi negatif, hasil penelitian sebagian besar menunjukkan asosiasi negatif pasangan spesis gastropoda di ekosistem lamun.Kata kunci : Gastropoda, Kepadatan, Diversitas, Dominansi, Asosiasi

Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017

Point prevalence surveys of healthcare-associated infections (HAI) and antimicrobial use in the European Union and European Economic Area (EU/EEA) from 2016 to 2017 included 310,755 patients from 1,209 acute care hospitals (ACH) in 28 countries and 117,138 residents from 2,221 long-term care facilities (LTCF) in 23 countries. After national validation, we estimated that 6.5% (cumulative 95% confidence interval (cCI): 5.4-7.8%) patients in ACH and 3.9% (95% cCI: 2.4-6.0%) residents in LTCF had at least one HAI (country-weighted prevalence). On any given day, 98,166 patients (95% cCI: 81,022-117,484) in ACH and 129,940 (95% cCI: 79,570-197,625) residents in LTCF had an HAI. HAI episodes per year were estimated at 8.9 million (95% cCI: 4.6-15.6 million), including 4.5 million (95% cCI: 2.6-7.6 million) in ACH and 4.4 million (95% cCI: 2.0-8.0 million) in LTCF; 3.8 million (95% cCI: 3.1-4.5 million) patients acquired an HAI each year in ACH. Antimicrobial resistance (AMR) to selected AMR markers was 31.6% in ACH and 28.0% in LTCF. Our study confirmed a high annual number of HAI in healthcare facilities in the EU/EEA and indicated that AMR in HAI in LTCF may have reached the same level as in ACH